Revive Therapeutic Services

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

REVIVE THERAPEUTIC SERVICES

Practice address

2205 Woodleaf Rd Apt 7H
Salisbury, NC 28147-1181

Phone

(252) 762-9788

NPI assigned

Jan 25, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Leandra Salley, MSW

Title

Partner

Phone

(252) 762-9788

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548374400000",
    "number": "1609330463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 WOODLEAF RD APT 7H",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281471181",
            "telephone_number": "252-762-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 WOODLEAF RD APT 7H",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281471181",
            "telephone_number": "252-762-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-25",
        "last_updated": "2019-01-25",
        "status": "A",
        "authorized_official_last_name": "SALLEY",
        "authorized_official_first_name": "LEANDRA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "252-762-9788",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ann Rendon
• Leslie Sierra Renten, M.D.
• Hernane C Restar
• Alexandra Reustle, PSY.D.
• Revive Housing LLC
• Shomara Reyes
• Yeimi Lizbeth Reyna Romero
• Brooke Reynolds
• Jesse Reynolds, PT
• John Ozment Reynolds, M.D.

• Addiction (Substance Use Disorder) Counselor in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.